With all due respect, just because MD's are opening up opticals in their offices, does not mean they are profitable. MD's think they are profitable because they have seen OD's do well in the past. MD's are getting killed by Medicare so they are looking for more profit centers and that's why they open them. I bet if you look at the actual profits that the majority of MD's are making from their opticals it is much less than they thought it would be. If you want to look at trends, then look at the fact that most optometric consultants are now telling OD's to focus more on the medical side of their practices.
I did not fully articulate my point about LensCrafters not really being our competition. What I mean by that is, they (the boxes) have already beat us in the discount eyewear market. They are not our competition because we should not want those patients buying from us. Those are the patients that are looking for the cheapest pair of glasses they can find. They are the ones that only get what VSP pays for. We cannot make a profit on those patients, and so we should have no problem letting them go to the boxes. You don't see the boxes saying, wow Dr. Chudner is taking away all of our Varilux Ipseo with Crizal Alize' patients. We need to find a way to compete with him. They don't do that because they can't compete with me for those patients. Those are the patients I want. Those are the ones I can actually make a profit on. The best you can do is educate your patients on why your products are worth the extra money and let them decide. I guarantee you that it takes only one Ipseo patient to make up for 4 patients you lose to LensCrafters.
About medical eyecare, I agree there is not a lot of disease in optometric practices. I would go even farther to say that a lot of general OMD's in private practice don't even see a lot of disease. They may do a lot of cataract surgeries, but just like the MD's you work with, there is not a lot of disease in most areas for the average cataract surgeon. Just because there is not a lot of disease, however, does not mean there is not a lot of medical eyecare billing you can do. For example, there is a lot of dry eye in my area. Not the sexiest disease, and probably not one you think of when you think medical eyecare, but punctal plugs pay a lot more than a CR-39 single vision uncoated lens in a Safilo frame. And there is less overhead involved which makes the profit go up even more.
My point is that medical eyecare is not only waiting for that patient to come in with a CRVO. There are a lot of diagnostic procedures you can perform on patients with glaucoma (estimated at 12% of the population, I believe), diabetes (epidemic numbers), dry eyes, etc that will make you more money than you will in optical. My biggest fear for optometry is that those docs that refuse to move into the medical model will eventually die off due to the boxes. One last point - in the average OMD office, 70% of the patients have been seen more than once during the course of the year. You and I both know there is not that much actual disease out there.
....Oh boy
.... The ridiculous part was that after being examined by my younger brother, the patient noticed his medical diploma and then asked him to throw in, at no extra charge, a Physical and digital rectal examination of his prostate because he was told a year earlier by his PCP that he had a slightly enlarged prostate. 😱 After that experience he took his diploma out of the exam room.
